Amanda LaChance
Dracut,MA
Summary
Dynamic Authorization Specialist with proven expertise at Lowell General Hospital, adept at processing prior authorizations and ensuring compliance with HIPAA regulations. Recognized for enhancing efficiency and accuracy in claims management while fostering strong relationships with insurance representatives. Excellent communication and problem-solving skills drive successful outcomes in high-pressure environments.
Overview
25
25
years of professional experience
Work History
Authorization Specialist
Lowell General Hospital Main Campus
Lowell, MA
07.2001 - Current
- Processed patient authorization requests efficiently and accurately.
- Collaborated with healthcare providers to verify insurance coverage details.
- Utilized electronic health record systems to track authorization status.
- Ensured compliance with regulatory requirements in authorization processes.
- Resolved discrepancies in patient information to facilitate timely approvals.
- Assisted team members in navigating complex authorization cases effectively.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Assisted in training new team members on company policies and procedures for handling authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Increased accuracy by diligently reviewing and verifying patient eligibility, coverage, and benefits information.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Developed strong relationships with insurance representatives to expedite approvals and resolve issues promptly.
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
- Promoted positive customer experiences by addressing concerns or questions related to authorizations in a professional manner.
- Trained staff on current eligibility requirements and policies.
- Provided training and support for new staff on authorization protocols.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
Education
High School Diploma -
Greater Lowell Technical H.S
Tyngsboro, MA06-2001
Skills
- Medical terminology expertise
- Claims management
- Insurance verification
- Data entry proficiency
- HIPAA compliance
- Prior authorization processing
- Effective communication skills
- Microsoft office
- Verbal communication
- Data entry
- Record keeping
- Telephone etiquette
- Benefits administration
- Medicaid
- Confidentiality
- Authorizations
- Teamwork and collaboration
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking Abilities
- Reliability
- Excellent communication
- Critical thinking
- Organizational skills
- Task prioritization
- Self motivation
- Information gathering
- Document preparation
Timeline
Authorization Specialist
Lowell General Hospital Main Campus
07.2001 - Current
High School Diploma -
Greater Lowell Technical H.S